Medical Leadership Position

1 day ago


San Diego, California, United States Optum Full time
Optum Career Opportunity

We are seeking a Medical Director to join our team at Optum Home & Community Care, part of the UnitedHealth Group family of businesses.

As a Medical Director, you will play a vital role in helping us create something new in health care. We are uniting industry-leading solutions to build an integrated care model that addresses an individual's physical, mental and social needs.

You will help change the way health care is delivered from hospital to home, supporting patients transitioning across care settings. This life-changing work helps give older adults more days at home.

Job Responsibilities
  • Provide daily utilization oversight and external communication with network physicians and hospitals
  • Daily UM reviews - authorizations and denial reviews
  • Conduct peer to peer conversations for the clinical case reviews, as needed
  • Conduct provider telephonic review and discussion and share tools, information, and guidelines as they relate to cost-effective healthcare delivery and quality of care
  • Communicate effectively with network and non-network providers to ensure the successful administering of Care Transitions' services
  • Respond to clinical inquiries and serve as a non-promotional medical contact point for various healthcare providers
  • Represent Care Transitions on appropriate external levels identifying, engaging and establishing/maintaining relationships with other thought leaders
  • Collaborate with Client Services Team to ensure a coordinated approach to delivery system providers
  • Contribute to the development of action plans and programs to implement strategic initiatives and tactics to address areas of concern and monitor progress toward goals
  • Interact, communicate, and collaborate with network and community physicians, hospital leaders and other vendors regarding care and services for enrollees
  • Provide leadership and guidance to maximize cost management through close coordination with all network and provider contracting
  • Regularly meet with Care Transitions' leadership to review care coordination issues, develop collaborative intervention plans, and share ideas about network management issues
  • Provide input on local needs for Analytics Team and Client Services Team to better enhance Care Transitions' products and services
  • Ensure appropriate management/resolution of local queries regarding patient case management either by responding directly or routing these inquiries to the appropriate SME
  • Participate on the Medical Advisory Board
  • Providing intermittent, scheduled weekend and evening coverage
Requirements
  • Board certification as an MD, DO, MBBS with a current unrestricted license to practice and maintain necessary credentials to retain the position
  • Current, unrestricted medical license and the ability to obtain licensure in multiple states
  • 3+ years of post-residency patient care, preferably in inpatient or post-acute setting

The estimated salary range for this role is $286,104 to $397,743 per year. Benefits include a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution.



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